Expert urges diabetics to get proactive to prevent complications

By Marissa Harshman, Columbian health reporter


photoRobin Hammon

If you go

What: The American Diabetes Association’s annual fundraiser, Oregon/Southwest Washington Tour de Cure, will take place in Hillsboro, Ore. Versions of the cycling event take place in 44 states across the country and raise money to fund diabetes research. There will be bicycle rides of 5, 26, 43, 65 and 100 miles.

When: Start time is 5:30 a.m. July 28.

Where: Hillsboro Stadium, 4450 229th Ave., Hillsboro, Ore.

Cost: $25 registration fee; fundraising minimum of $150.

Nearly 26 million Americans — about 8 percent of the U.S. population — have diabetes. And another 79 million people are on their way to a diabetes diagnosis, according to the American Diabetes Association.

Despite the prevalence, many don't understand the disease, its risk factors or ways to manage it.

Diabetes is a disease affecting how one's body uses blood glucose, or blood sugar. During digestion, sugar is absorbed into the bloodstream. Normally, sugar then enters cells, with the help of insulin.

When a person eats, his or her pancreas secretes insulin into the bloodstream. As insulin circulates, it acts like a key, unlocking doors that allow sugar to enter cells, according to the Mayo Clinic.

A person with diabetes has too much glucose in their blood. The reason behind the excess glucose distinguishes Type I from Type II diabetes.

Type I

Type I diabetes is when the body's immune system destroys the beta cells in the pancreas. Without the beta cells, the body is incapable of producing insulin, said Robin Hammon, registered dietitian and diabetes educator at Legacy Salmon Creek Medical Center.

Without insulin, sugar remains in the bloodstream. So people with Type I diabetes must rely on insulin injections or an insulin pump, Hammon said. Insulin pumps deliver insulin 24 hours a day through a catheter placed under the skin.

Typically, people with Type I diabetes are diagnosed before the age of 20, however, some are diagnosed later in life. The disease is not reversible and stays with the person for the rest of his or her life, she said.

Researchers don't know exactly what causes Type I diabetes, but one theory is environmental factors somehow play a role. Many times people are diagnosed with Type I diabetes after contracting an illness, Hammon said.

One thing researchers know is those who have Type I diabetes have some sort of genetic susceptibility to the disease, she said.

Type II

Type II diabetes is the result of the body not managing glucose. While Type II diabetics' bodies do still produce insulin, at least in the early stages, the cells become insulin resistant, Hammon said. As a result, sugar is remaining in the bloodstream and not entering the cells, she said.

Excess weight, especially in the belly area, causes insulin resistance, making it a risk factor for Type II diabetes. Growing older is another risk factor for Type II diabetes. As a person ages, he or she becomes less capable of processing glucose, Hammon said.

Other risk factors are family history, physical inactivity and race. Blacks, Hispanics, Indians and Asians have higher incidence rates of Type II diabetes. People with a history of gestational diabetes, which is high blood-sugar during pregnancy, are also at risk, Hammon said.

Physicians can also diagnose a person with prediabetes, which is the stage before a Type II diagnosis. In prediabetes, a person's blood-sugar levels are elevated but not yet to the point of being diabetic. Those who have prediabetes and don't make lifestyle changes usually become diabetic within 10 years, Hammon said.

"With good blood-sugar control, whether Type I or Type II, a person can reduce those risk factors," she said. "A person with diabetes can have a healthy life."

Studies have shown that adjusting one's diet to include less carbohydrates, losing 7 percent of one's body fat and exercising 30 minutes at least five days a week can help

slow or stop the progression of the disease, Hammon said.

In addition to diet and exercise, some people with Type II diabetes may need medication to help lower blood-sugar levels.

Diabetes management

While diet and exercise can help to manage diabetes, failing to keep blood-sugar levels under control can have the opposite effect.

People with Type I diabetes can become insulin resistant if they become overweight or obese, Hammon said. Exercise improves the way the body uses insulin, enabling the person to reduce the amount of insulin needed through injections, she said.

Poor blood-sugar management can also affect people with Type II diabetes.

Someone who has had Type II diabetes for 15 or 20 years or who hasn't managed their blood-sugar levels well could cause damage to their beta cells. Over time, high blood-sugar becomes toxic and destroys the cells, meaning the body won't produce enough or any insulin on its own anymore, Hammon said. As a result, medications won't manage the disease, making insulin necessary, she said.

To prevent complications, Hammon recommends diabetics get proactive.

Hammon suggests people who are diagnosed enroll in a diabetes education program, which includes training on managing blood-sugar levels, following a healthful diet and reducing risk. Diabetics should also get a yearly wellness exam, blood tests every six months, an annual eye exam and a yearly foot exam because feet are susceptible to neuropathy, which is the loss of feeling or a tingling sensation due to nerve damage, Hammon said.

"Everybody can reach target," she said. "It may take more than lifestyle changes. It may taken medication. It may take insulin. But that's the good news. We can get good blood-sugar control."

Marissa Harshman: 360-735-4546;;;